Efficacies of intrauterine balloon tamponade, intrauterine gauze tamponade and B-Lynch suture in prevention and treatment of postpartum hemorrhage / 第二军医大学学报

ABSTRACT

Objective To investigate the efficacies of intrauterine balloon tamponade, intrauterine gauze tamponade and B-Lynch suture in prevention and treatment of postpartum hemorrhage. Methods A total of 266 patients with high risk of postpartum hemorrhage or postpartum hemorrhage in our hospital from January 2013 to October 2014 were included in this study. They received intrauterine Bakri balloon tamponade (n=114), intrauterine gauze tamponade (n=69) or B-Lynch suture (n=83). The hemostatic effects of three methods and their relationship with different hemostasis occasions and high risk factors were analyzed. Results The hemostatic rates of intrauterine balloon tamponade, gauze tamponade and B-Lynch suture were 90.4%, 94.2% and 92.8%, respectively, with no significant differences found between the 3 groups (P>0.05). The hospitalization time, postpartum infection or involution of the uterus of three methods were not significantly different (P>0.05). The operation period was (46.08±13.8) min for intrauterine Bakri balloon tamponade, (56.49±12.94) min for intrauterine gauze tamponade, and (52.36±21.11) min for B-Lynch suture,with that of Bakri balloon group being significantly shorter than the other two groups (P<0.01). As for hemostatic occasion, 134 cases received preventive hemostatic treatment and were all successful, while 132 cases receiving hemostatic treatment had a successful rate of 84.1%, being significantly lower than that of the prevention hemostasis group (P<0.01); moreover, the postpartum infection rate was significantly lower in the prevention group compared with hemostatic treatment group (P<0.01). When placenta factor and uterine factor exist at the same time, the bleeding rate and bleeding volume of the mixed factor were significantly higher than that of single factor (P<0.01). Conclusion The three hemostasis methods have no differences in their hemostatic effects, hospitalization time, postpartum infection and uterine involution, with Bakri balloon's operation having the shortest time, therefore it may serve as an emergency hemostasis method to win more time for further treatment. The success rate of hemostasis depends not on the hemostasis method, but on the right occasions, the earlier the better. When placenta factor and uterine factor exist at the same time, the failure rate of hemostasis is higher, and emergency plans should be taken to reduce postpartum hemorrhage as soon as possible.